[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR412.78]



[Page 499]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 412_PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES

--Table of Contents

 

   Subpart E_Determination of Transition Period Payment Rates for the 

        Prospective Payment System for Inpatient Operating Costs

 

Sec. 412.78  Recovery of excess transition period payment amounts 

resulting from unlawful claims.



    If a hospital's base-year costs, as estimated for purposes of 

determining the hospital-specific portion, are determined, by criminal 

conviction or imposition of a civil money penalty or assessment, to 

include costs that were unlawfully claimed, the hospital's base-period 

costs are adjusted to remove the effect of the excess costs, and CMS 

recovers both the excess costs reimbursed for the base period and the 

additional amounts paid due to the inappropriate increase of the 

hospital-specific portion of the hospital's transition payment rates.



[50 FR 12741, Mar. 29, 1985, as amended at 57 FR 39822, Sept. 1, 1992. 

Redesignated at 65 FR 47106, Aug. 1, 2000]